Elaine Taylor-Klaus:�Welcome back, everybody. We are excited to have a conversation with our guest today, Dr. Sarah Cheyette, who is a pediatric neurologist, and we are going to be having a conversation about what's most important for parents to understand when raising teens and young adults with ADHD. So welcome, Sarah. We're thrilled to have you.

Sarah Cheyette:�Thanks for having me.

Diane Dempster:�Awesome. So Sarah, why don't you start by telling us a little bit about what you do with families of complex kids and how you ended up in the work that you do?

Sarah Cheyette:�Well, so a pediatric neurologist deals with brain issues. Also, muscle and spinal cord, but for right now, it's for the part that's most important is the brain. And so we deal with kids who have differences in development, which include things like autism and ADHD, and some pediatric neurologists also get into more anxiety and depression, and learning issues. So anything that has to do with the brain is fair game.

Diane Dempster:�Awesome. And how did you end up doing this work? What's part of your path?

Sarah Cheyette:�It's actually interesting. I came to think about ADHD in the context of difficult headache patients. So I had a couple of teens who had these headaches that just were constant and would not go away. And it turned out that because of the stress of the ADHD, they were having headaches all the time. And to fix the headaches, I had to start dealing with the ADHD. And so most of my ADHD patients do not have headaches, but that's how I started because one of the things that pediatric neurologists treat is headaches.

Elaine Taylor-Klaus:�So did you notice the trend of a lot of these kids already had ADD, or did you discover the ADHD in the process?

Sarah Cheyette:�Yeah, they were going around seeking treatment for the headache pain, but in trying to talk about what went into the headache pain, they're having a hard time in school, and that's a constant stressor for them. And they're having a hard time at home. And so you could treat those kids with every headache medicine, and they wouldn't get better. But if you started talking about and treating the ADHD, the headache got better. So it's an unusual way to leap into the ADHD field, I think, but that's how I got there.

Elaine Taylor-Klaus:�That's fabulous. Yeah. Well, and I think that's probably true in a lot of arenas with ADHD that when you treat the underlying ADHD, all kinds of other things probably get better. I know, for me, my anxiety got so much better.

Sarah Cheyette:�Anxiety is huge. Sometimes it's hard to know whether the difficulty in concentrating is from ADHD or from anxiety. Oftentimes it's both. Sometimes it's mostly anxiety. Anxiety makes it harder to concentrate on things. So by the time kids are in the double digits of numbers, a lot of time has gone by, and a lot of mindsets develop. And so it's not necessarily, oh, it's ADHD, oh, it's anxiety. It's often a lot of everything mixed together. Not to mention depression and poor self-esteem, which I don't think is quite the same as depression. And sleep issues too.

Elaine Taylor-Klaus:�Yeah. All of which we hear from parents all the time. I want to check in with you because I often say to parents I want to check and see if I'm accurate. I often say when you have ADHD that's not being treated, you can't get yourself to do what the world expects you to do, and that's going to make you anxious. And over time, that will often lead to depression. Does that sort of sequence make sense to you?

Sarah Cheyette:�Yes. I don't know if it's quite so sequential. That's valid. Let me start by saying that but some people respond differently. Some people respond more depressed/self-esteem and anxious. We all have different tendencies, so I can't necessarily say that the sequence is reliable, but all of those things can happen and can go together depending on how you're built. When we study what to do, it's like we read the ADHD chapter, and we have the ADHD medications, and we read the anxiety chapter, and we have the anxiety medicines, but it's often not so easy to parse people out in these little labels.

Diane Dempster:�Well, and what's coming up for me is one of the things we like to talk about is what is the things that parents need to understand better in order to identify when is anxious okay? When is it ADHD? When does it get to be troublesome enough that you should do something about it? That sort of thing.

Sarah Cheyette:�Yeah. And you know, I'm excited to be on the podcast today because sometimes, when people come to my office, all this has been going on for a long, long time. And these patterns have been just sewn into the relationship. And so sometimes I'm like the mop-up crew or whatever putting out the fire after it's already become an inferno. I think that's more apt.

Elaine Taylor-Klaus:�I do know how you feel.

Diane Dempster:�Absolutely.

Sarah Cheyette:�Bet you do.

Elaine Taylor-Klaus:�I'm totally used to that.

Sarah Cheyette:�I bet you do. So I think that's why I started to do the book writing. It's like, I'd like to talk to people before they come seek out help because, by that time, it's often difficult.

Elaine Taylor-Klaus:�So that's a common question that we get from parents. So we work with parents. We used to say four to 24; now we say three to 33 because we're getting a lot of parents, young adults. And oftentimes, after the kids are about 10, the parents are worried it's too late, 10 or 12, certainly past puberty. They come in with the story they're telling themselves that it's too late, that they've missed the boat. And you're really here talking about teens and young adults. So let me start by asking a yes or no question. Is it too late?

Sarah Cheyette:�Of course not. Never.

Elaine Taylor-Klaus:�Great. Let's talk about that a little bit.

Sarah Cheyette:�I have adult patients who are remaking their lives as 50-year-olds. So it's only too late if you say it's too late. It's never too early to begin, and it's never too late to keep working at it, I guess, is what I'm trying to say. Life is a process.

Elaine Taylor-Klaus:�So if you're starting, let's say, after puberty or after once you've got some, some infernos in place. It's been going on a long time and hasn't yet been well-addressed. What do parents need to understand to begin to shift their mindset to one where they're able to support?

Sarah Cheyette:�So I think the main thing is that a school year's going to come and go, and grades are going to come and go. You'll get the grades, or you won't get the grades, but you can't do anything for your kid unless you can make a connection with your kid. So to get your kid from point A, wherever their point A is, to point B, which is where you're envisioning you want to be, you got to start at point A. And I think sometimes the best thing you can do with the kid is take the kid out for ice cream. Just sit there and eat ice cream.

Elaine Taylor-Klaus:�And not talk about school.

Sarah Cheyette:�Not even talk about anything if you don't want to. Just sit there and eat the ice cream.

Diane Dempster:�Eat ice cream. That sounds good to me.

Sarah Cheyette:�You know what, there are days, right? So just sort of finding a way to make a connection in a non-threatening I'm not trying to change you way. It doesn't have to be ice cream. You could do a walk or whatever. I just think it's easier to talk people into sitting and eating ice cream than pretty much anything I can think of. So the connection is the important thing, and being able to see things from your child's point of view is also important, too, stepping out of yourself and trying to see things from your child's point of view. Listening is a good idea.

Diane Dempster:�Yeah. Well, and as you're saying that what's coming up is like, as we were talking about that interplay between anxiety and ADHD, I'm wondering whether kids are generally more comfortable talking about feelings of anxiety than they are of feelings that they can't get their brain to do what they want it to do.

Sarah Cheyette:�I think the anxiety is often the more obvious thing for people. They know they're worrying. They don't necessarily know why they're worrying, and especially kids, don't usually have a lot of insight into, like, this is the executive part of my brain. They just know that they're behind. And so I think it's the obvious thing is the panic attack. The less obvious thing is what's going into it.

Elaine Taylor-Klaus:�Well, I was thinking about. I was sharing with you earlier that I have a daughter who's been studying for the MCATs, really intense studying. And what she noticed, she struggles with both anxiety and dyslexia and so as ADHD. And what she noticed was that the anxiety was the biggest problem because she began to get anxious about what was going to happen if the dyslexia kicked in or became a trouble. So they were playing off of each other, but ultimately the anxiety is what would really derail.

Sarah Cheyette:�Yeah. And what people don't realize is that the anxiety part of your brain turns off the rational thinking part of your brain. And so when you're anxious, whatever you're thinking about, you're not thinking about it very well. Now it seems real. It seems like that's reality, but it's not really because you all know that when you calm down and think about it later, it never feels the same way. Never is the same thought process, and that's a neurological thing. There is direct connections because when you get anxious, your body doesn't want you to think through wow, is that really a tiger there? I'm not sure. Do tigers have spots or stripes?

Diane Dempster:�Maybe I'll be okay if I'll stand here.�

Elaine Taylor-Klaus:�Maybe it's a leopard, not a tiger.�

Sarah Cheyette:�Right, exactly. I like leopards. They're big cats. What's wrong with cats? So the people who survived were the people whose brains said, run. Don't think. So that's how we're all built now.

Elaine Taylor-Klaus:�Yeah. So from your perspective, so I love what you're saying. I think Diane and I, we often say to parents, if you don't know what to do, there are two places to look, either lean into self-care or lean into relationship. And if possible, do both. That's the big picture. So I really love this message of really focus on the relationship, focus on the connection and the communication. A lot of parents at first will struggle with that because there's so much to do. They're worried about what needs to be done or their kid falling behind. So can you speak to that a little bit?

Sarah Cheyette:�You know, it's not a race. There's going to be time. Until you can make that connection and be together at that point A, you really can't do anything else. And if you have an anxious kid, there's a good chance that you yourself are operating out of anxiety, too, because it's a heritable genetic type of tendency. So there's time. We all have timelines in our head, but they're generally artificial.

Diane Dempster:�It's like the lion, right? It's just sort of that we see a lion in our head because we're afraid for our kids' future instead of going that's the opposite. We just, you know what? I do need to take a deep breath and be willing to consider that I can wait a little while or I can take the time to connect with my kid.

Elaine Taylor-Klaus:�So maybe it was just a cat, not a lion.

Diane Dempster:�It really is a cat, not a lion.�

Sarah Cheyette:�And also, take the time to recognize that it's probably your personal characteristics that are more correlated with success, right? So it's not your grades so much as your ability to persevere and to recover from failures and all these other things. So I know we're all about the SATs and all about the GPAs and all these other abbreviations, but it's not what college you go to. It's who you are when you get there. So there's no hurry, but all three of us are seeing people in crises a lot of times. We see people who we have to sort of get on the right road, but we can only do so much in the office. You guys have to have a relationship at home. It's about the two of you. I can give you some advice, but it's really about your relationship more than anything else and how you repair that.

Diane Dempster:�I'm heading two different directions. There's part of me that wants to talk about how to rebuild relationships, and there's part of me that talk wants to talk about the, once you've got that foundation because we've got you and your physician on the hook here. Can we talk about, okay, I've got a good relationship with my kid, or I've got a decent relationship with my kid, how do I talk to them about the anxiety, how do I talk to them about the ADHD? How do I help them maneuver through that process, assuming I have a good relationship?

Elaine Taylor-Klaus:�Well, and can I just piggyback on that? What I heard is first relationship, and then what I hear Diane saying is, okay, so then what's the next step?

Sarah Cheyette:�Okay. So again, we all are programmed to notice the bad things. There's a negativity bias in our brains, meaning that the bad things stand out. And again, that's probably evolutionary. So if you're trying to get your kid to get some work done, homework, or whatever, again, see it from their perspective. I have a lot of parents of eight-year-olds telling me, ah, that kid just wants to finish it quickly and doesn't care the quality of the work. Like yeah, of course. I mean, if you were eight and four years ago, you were just playing with Play-Doh, and nobody says, oh, you like Play-Doh, do Play-Doh. And then you're like, whatever coloring, do coloring. If you don't like doing this, you don't have to do that. And then all of a sudden, they're 5, 6, 7, 8, and people are handing them stuff. They're like, what is this? And I don't want to do it, so forget it.�

Elaine Taylor-Klaus:�Can you blame them, right?

Sarah Cheyette:�Not, not really. So the stuff that's obvious to parents, which is like, people who try their best are good people and try harder. These are not things that is natural or obvious to a littler kid. So I have 15-year-olds who come into my office going, like, Dr. Cheyette, look at this report card. I got a bunch of As. And I'll say, wow, that must have been really hard. A lot of hard work went into that. They're like, yes. And I'll be like, you spent the last five years telling me that you wanted to avoid working hard. They'll be like, oh yeah. Right. So pointing out the good feelings is where I'm going to this. When people complete work, they don't take the time to notice that that is a really good feeling. And if you don't notice that, then it's just work. For an eight-year-old, it's just something to get through so you can do the other stuff.�

Elaine Taylor-Klaus:�About what you just said, Sarah, was that it wasn't, I'm proud of you, but you really said effectively you must be really proud of yourself.

Sarah Cheyette:�Yeah. Or what a good feeling it is.�

Diane Dempster:�Yeah. And it wasn't about the A; it was about the work.�

Sarah Cheyette:�It's not about the work; it's about the feeling. It's what I would say. The work isn't important. You will learn about the I don't know, what do people learn about social studies and math stuff and factoring and algebra and stuff like that. You'll learn it, or you won't. But the feeling of accomplishment, that's the point of all of this. It's a good feeling. And if you pay attention to that, you want to do it more and more. If you don't pay attention to that, it's like, oh, got through that. Got through that. Got through that.

Elaine Taylor-Klaus:�You know, the other thing that's coming up for me as you're saying this is that I think the other thing you're pointing to is this values issue. The parents have a value around the work ethic, and the kid at eight doesn't yet have it. And so the parent becomes worried that you've got this moral failure, and I see this a lot with the issue of lying.

Sarah Cheyette:�With what?�

Diane Dempster:�Lying.

Elaine Taylor-Klaus:�Lying and truth-telling is that the parent has a really strong value around honesty, and a kid tells a lie, and they feel like this kid's going to jail. So there is something here.

Sarah Cheyette:�And the kid is feeling like, wow, how clever, look what I did.

Diane Dempster:�And I got to fix it now. The lion shows up again. It's, oh my gosh, this is terrible. My kid is a liar. I've got to nip it in the bud, or he's going to end up a pathological liar.

Sarah Cheyette:�[inaudible] and�all that stuff. So yeah, that's the most expedient way for kids to get out of the situation. It feels terrific to them. They feel clever. And you're like, you are going to be in big trouble. They're like, why? I just did something fantastic.

Elaine Taylor-Klaus:�So what would you say to parents about that? We've come up with two, and there are probably a dozen examples of places, whereas as parents, we catastrophize our typical kids' behavior and begin to worry that it's some indication of who they are for the rest of their life because morally they're not developing properly or something. How do you address that with parents?

Sarah Cheyette:�I would say there's a couple of different things. I would acknowledge, like yeah, it really did get you out of that situation. That was the positive. That's why you keep doing it. But on the other hand, here's the negative. I can't believe a word you're saying. You have to be supervised. So sort of a lack of trust and trying to get them to understand what it feels like to be lied to sort of from the parent's perspective. It's like, yeah, you got away with it in the short term, but in the long term, your parents are not going to let you go on that website without supervising. Would you trust yourself? Nobody would bet money on you kid, so I'm trying to get them to understand it from the other perspective is where, because I think that from a parent-child relationship, that trust or lack of trust, how it gets to be that influences a lot of different aspects.

Elaine Taylor-Klaus:�Well, and what I love about what you're saying is that it's not coming from a place of judgment or shame or blame. It's coming from a place of understanding and helping the kid have a reason to want not to lie, which is I want my parent to trust me so that I don't have to be supervised.

Diane Dempster:�It's a natural consequence. And I think that that's one of the things that it's hard to keep it as a natural consequence and not have it show up as judgment. And it sounds like that's an important piece. It goes back to that relationship and the trust.

Sarah Cheyette:�I think so. I never thought about it that way, but yeah, in general, the best motivation is one that comes from you, not from a fear of a consequence of my parents will catch me or somebody will catch me because that just drives me to try to be more clever, you know what I mean? Try to get around it better. Cover my tracks. So I think the self-motivation is what we're trying to build because when the parents go away at college time or whenever it's going to be, you really have to have that motivation within yourself.�

Elaine Taylor-Klaus:�For sure. So I think what I'm hearing you saying is that parents can really have a more powerful impact on their kids by letting go of all the doing stuff and really focusing on being in relationship and cultivating relationship and also in helping the kids find their own motivation instead of some external. Anything else?

Sarah Cheyette:�You�know, most of the time, parents will talk down to younger kids at some level. They're trying to parent. They may be playing their own parent tapes in their head, how they themselves were parented. But if you let a kid talk, the kid will often be pretty insightful as to what's going on in their head and trying to figure out. Really how they're thinking depends on a lot of listening. I'm a big proponent of giving kids responsibilities. I guess this is all part of respecting the kid as a person. So I think it is important for parents to lead the kids and tell them things that they should do and give them responsibility. But part of that is not talking down to them but talking to them not necessarily like an equal, but valuing what they have to say and making sure that that's part of the interchange. I mean, we all have to tell our kids to pick up things, and there will always be those things coming out of your mouth, but asking the kids what do you think about what the dynamic is here? What do you think about how you're doing? And listening to the answer is really very valuable.

Diane Dempster:�Yeah. Well, and it's that distinction between mutual respect and finding a way to not feel like you're losing your power as a parent because I think a lot of parents get really worried that they're somehow getting undermined by showing their kid respect.

Sarah Cheyette:�Yeah. I think kids like to be shown respect, and they will grow into that respect. And so if you treat your kid like they're at the end of a leash, then that's how the kid will behave, including trying to get the leash off. Right. But the respect is something that they will value, and I think that's an important part of a lasting relationship. Also, walking the walk like it doesn't work if you're telling your kid not to be on their phone and you're on your phone all the time.

Elaine Taylor-Klaus:�Especially with teenagers and young adults.

Sarah Cheyette:�Oh my gosh, there's onto you. Right?�

Diane Dempster:�So they'll call you on it.

Sarah Cheyette:�Demonstrating the pleasure in real-life activities by having a bunch of them that you do, you can't be hypocritical. It just doesn't work.�

Diane Dempster:�Yeah. So Sarah, what's the best way for people to find out more about you or get in touch?

Sarah Cheyette:�Sure. I have a website. It's sarahcheyette.com. SARAHCHEYETTE.com.�

Elaine Taylor-Klaus:�And it will be in the show notes, so you can check that if you will.�

Sarah Cheyette:�Oh, okay. Good. So that's probably the best way to get ahold of me.

Elaine Taylor-Klaus:�Great. And you mentioned that you have a comic book that you wrote for children, just to mention what that is, and we'll put that in show notes as well.

Sarah Cheyette:�Yes.�I've written two ADHD books that have a lot of words in them. And so then I went into the comic book type of presentation, and it's just explaining ADHD in a positive way, and it's called ADHD and Me. So that's on Amazon, and I think it's kind of cute, actually.

Elaine Taylor-Klaus:� We'll have a link in the show notes as well. I love it. Diane, should we do our wrap? Anything else? Before I�go�into our wrap, I just want to say thank you because it's amazing to have this conversation with you.

Sarah Cheyette:�Oh, I have enjoyed it. Absolutely. Thank you, guys, for having me on your show. I look forward to all the episodes. I know you're starting with this, and I'm just going to be putting you guys on my Spotify or whatever it's going to be.

Elaine Taylor-Klaus:�Thank you.�

Diane Dempster:��Awesome. Thank you. So the question we want to wrap up with is if you have a favorite quote or a motto that you'd like to share with our parents that are listening.

Sarah Cheyette:�Oh my goodness. A favorite quote. I'd have to think about that a little bit more. I think it would be the do unto others. I really don't think you can beat the golden rule there, which is treat people with the respect and the way you'd want to be treated. And I think it will come back to you tenfold, really.

Elaine Taylor-Klaus:�Yeah, and I couldn't agree with you more as a parent. There's probably nothing more important that you can do than treat your kid with respect. They are autonomous individual beings, you kids.

Sarah Cheyette:�Unfortunately, right? Wouldn't it be easier if they had their off buttons and you have the little shock collar or control thing? I mean, geez, that would be terrific, but I think it's illegal.�

Diane Dempster:�I will say we might need to cut that part out.

Elaine Taylor-Klaus:�Maybe not shock collar.

Sarah Cheyette:�Yeah. Basically, I think respect is important, and responsibilities everything goes together if you treat them with respect. It also means that you're giving them some responsibilities. You know, I recently read the Laura Ingalls Wilder series to my kid, and I don't know, but what stood out for me is all the responsibilities back then that kids had. There was a lot of work to do, and people gave the kids a lot of work to do. And you know, the one that's called Farmer Boy, this nine-year-old boy was hauling logs and off on his own in the woods all the time, and wow, that was probably too much responsibility for a nine-year-old.

Elaine Taylor-Klaus:�But he wasn't doing three hours of homework every night.

Sarah Cheyette: No, that's true. But they went to school part of the year. But anyways, you're right. There were some pluses and some minuses, but it's okay to give your kids responsibility too.

Elaine Taylor-Klaus:�Love it. Yeah.

Diane Dempster:�Thank you so much, Sarah, for being with us today. It's been delightful to talk to you and look forward to what's next.

Sarah Cheyette:�You too, ladies. Have a great day.

Elaine Taylor-Klaus:�We'll see the rest of you on the next show. Take care, everyone.

Sarah Cheyette:�Bye.